Individual provider Active NPI

Rachel Vetter, FNP

  • Family Nurse Practitioner
  • Evergreen Park, IL
National Provider Identifier
1194573766
Registry record updated Jun 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209029903 Issued in IL
Practice address
3545 W 95TH St
Evergreen Park, IL 60805-2135
Phone
(708) 346-5562
NPI assigned
May 8, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041480802 IL
Family Nurse Practitioner 363LF0000X 209029903 IL Primary

Addresses

Primary practice location

3545 W 95TH St
Evergreen Park, IL 60805-2135

Mailing address

10591 W 154TH PL
Orland Park, IL 60462-6031
Phone (708) 250-8767

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240826002435 IL Practitioner - Nurse Practitioner 6608315379 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Consultants in Cardiology and Electrophysiololgy LLCGroup PAC ID 4880779727, 21 clinicians

Practice addresses (Care Compare)

3545 W 95TH St
Evergreen Park, IL 60805-2135
Phone (708) 346-5562

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
041480802ILMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Consultants in Cardiology & Electrophysiololgy LLC CurrentSince Aug 7, 2024 Accepting new patients

Locations

3545 W 95th St
Evergreen Pk, IL 60805
Phone (708) 435-9036

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1715126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1194573766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10591 W 154TH PL",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604626031",
            "telephone_number": "708-250-8767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3545 W 95TH ST",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052135",
            "telephone_number": "708-346-5562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VETTER",
        "first_name": "RACHEL",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-08",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041480802",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209029903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evergreen Park, IL

Sources for this page

Verify at the official NPI Registry.